Gaining Insight into Teenagers' Experiences of Pain after Laparoscopic Surgeries: A Prospective Study

Abstract

There is an anecdotal impression that teenage patients report exaggerated postoperative pain scores that do not correlate with their actual level of pain. Nurse and parental perception of teenagers' pain can be complemented by knowledge of patient pain behavior, catastrophizing thoughts about pain, anxiety, and mood level. Two hundred and two patients completed the study-56.4% were female, 89.6% White, 5.4% Black, and 5% were of other races. Patient ages ranged from 11 to 17 years (mean = 13.8; SD = 1.9). The patient, the parent, and the nurse completed multiple questionnaires on day one after laparoscopic surgery to assess patient pain. Teenagers and parents (r = 0.56) have a high level of agreement, and teenagers and nurses (r = 0.47) have a moderate level of agreement on pain scores (p < 0.05). The correlation between patient APBQ (adolescent pain behavior questionnaire) and teenager VAS (visual analog scale) and between nurse APBQ and teenager VAS, while statistically significant (p < 0.05), is weaker (r range = 0.14-0.17). There is a moderate correlation between teenagers' pain scores and their psychological assessments of anxiety, catastrophic thoughts, and mood (r range = 0.26-0.39; p < 0.05). A multi-modal evaluation of postoperative pain can be more informative than only assessing self-reported pain scores.

Keywords: anxiety; laparoscopic surgeries; mood; pain behavior; pain catastrophizing thoughts; teenager postoperative pain; visual analog pain scale.

Figure 1

Perioperative variables parents and nurses report influencing teenagers’ postoperative pain perception, mood, and catastrophic thoughts. Continuous measures are presented as mean ± standard deviation. r is the correlation coefficient; VAS is the visual analog scale; BMIS is the brief mood introspection scale; STAI-C is the state–trait anxiety inventory for children; PCS-C is the pain catastrophizing scale for children; APBQ is the adolescent pain behavior questionnaire; t is teenager; n is nurse; p is parent. The correlations were considered weak if values were 0.23 to <0.30, moderate if 0.30 to <0.50, and high if ≥0.50. Figure composed using Motifolio, Inc. diagrams.